诊断试验准确性网状Meta分析方法进展与挑战  

Advancements and challenges in network meta-analysis of diagnostic test accuracy

作　　者：郑卿勇 周泳佳 许建国 高亚[1,2,3] 刘明 葛龙 李伦 王权[9] 黄燕[10] 李江 张俊华 田金徽 ZHENG Qingyong;ZHOU Yongjia;XU Jianguo;GAO Ya;LIU Ming;GE Long;LI Lun;WANG Quan;HUANG Yan;LI Jiang;ZHANG Junhua;TIAN Jinhui(Evidence-Based Medicine Center,School of Basic Medical Sciences,Lanzhou University,Lanzhou 730000,P.R.China;Key Laboratory of Evidence-based Medicine of Gansu Province,Lanzhou 730000,P.R.China;Research Unit of Evidence-bacsed Evaluation and Guidelines,Chinese Academy of Medical Sciences,Lanzhou 730000,P.R.China;School of Nursing,Gansu University of Chinese Medicine,Lanzhou 730000,P.R.China;Evidence-Based Social Sciences Research Centre,Lanzhou University,Lanzhou 730000,P.R.China;Department of Health Policy and Management,School of Public Health,Lanzhou University,Lanzhou 730000,P.R.China;Department of General Surgery,The Second Xiangya Hospital,Central South University,Changsha 410011,P.R.China;Clinical Research Center of Hunan Province,Changsha 410011,P.R.China;Ambulatory Surgery Center of Xijing Hospital,Fourth Military Medical University,Xi’an 710068,P.R.China;China Medical University,Shenyang 110122,P.R.China;National Cancer Center/National Cancer Clinical Medical Research Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,P.R.China;Evidence-Based Medicine Center,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,P.R.China)

机构地区：[1]兰州大学循证医学中心,兰州大学基础医学院,兰州730000 [2]甘肃省循证医学重点实验室,兰州730000 [3]中国医学科学院循证评价与指南研究创新单元,兰州730000 [4]甘肃中医药大学护理学院,兰州730000 [5]兰州大学循证社会科学中心,兰州730000 [6]兰州大学公共卫生学院卫生政策与管理学系,兰州730000 [7]中南大学湘雅二医院普通外科,长沙410011 [8]湖南省乳腺疾病临床医学研究中心,长沙410011 [9]空军军医大学西京医院日间手术中心,西安710068 [10]中国医科大学,沈阳110122 [11]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院癌症早诊早治办公室,北京100021 [12]天津中医药大学循证医学中心,天津301617

出　　处：《中国循证医学杂志》2025年第3期349-357,共9页Chinese Journal of Evidence-based Medicine

摘　　要：本研究全面回顾了诊断试验准确性网状Meta分析(DTA-NMA)的理论基础、发展沿革、实践应用及潜在挑战。作为一种评估和比较不同诊断试验准确性的方法,DTA-NMA通过整合直接和间接证据,在提高诊断准确性与优化治疗策略方面显示出其独特价值,为临床决策提供了重要支持。然而,尽管在方法学和实践方面取得了显著进展,DTA-NMA在实施过程中仍面临多重挑战,包括提升研究透明度、整合多元证据、准确评估偏倚风险、呈现和解释结果以及评价证据质量等问题。未来,进一步完善针对DTA-NMA研究的报告规范和证据质量分级将是该领域发展的关键,这有助于支持基于证据的高效医疗决策,最终提升患者的诊疗效果。本研究旨在为进行DTA-NMA研究的学者提供思考和启示,促进该领域的稳步发展。This study comprehensively reviews the theoretical foundations,historical development,practical applications,and potential challenges of network meta-analysis of diagnostic test accuracy(DTA-NMA).DTA-NMA,as a method for evaluating and comparing the accuracy of different diagnostic tests,demonstrates its unique value in improving diagnostic accuracy and optimizing treatment strategies by integrating direct and indirect evidence,providing crucial support for clinical decision-making.However,despite significant progress in methodology and practice,DTANMA still faces multiple challenges in implementation,including enhancing research transparency,integrating diverse evidence,accurately assessing bias risks,presenting and interpreting results,and evaluating evidence quality.In the future,further refinement of reporting standards and evidence grading specific to DTA-NMA research will be crucial for the development of this field,facilitating evidence-based efficient medical decision-making and ultimately improving patient outcomes.This study aims to provide scholars conducting DTA-NMA research with reflection and insights to promote the steady development of this field.

关 键 词：诊断准确性试验 网状Meta分析 方法学 研究进展 

分 类 号：D92[政治法律—法学]